Severe forms of painful mucositis often occur both in oncology and organ or bone marrow transplantation with concomitant immunosuppressive therapy. They can only be counteracted by systemic analgesics, in particular opioids, combined with heavy support therapies. In many cases, onset of severe mucositis is the cause of suspension of chemotherapeutic treatments, thus allowing the tumor to continue its growth.
Radical treatments can induce side effects mainly affecting the gastrointestinal tract, particularly the mouth, esophagus, stomach, intestine and in some cases even the genito-urinary tract.
Medicaments which most frequently induce mucositis are anthracyclines, fluorouracil and analogues; and others, such as taxol, actynomicin, mithramycin, etoposide, topotecan, amsacrine, methotrexate, hydroxyurea, alone or in combination with other chemotherapeutics such as platinum complexes commonly used in cancer therapy. The combination of chemo- and radio-therapy in some districts, such as in head and neck therapy, causes mucositis in 95% of treated patients.
Conventional treatments for mucositis involve the administration of non-gastrolesive anti-inflammatory agents, analgesics, antimicrobials, antifungals, H2 antagonists and protective gels which help to maintain the affected area hydrated. Local pain is a side-effect which restricts the rational administration of the other drugs. The patient under such conditions experiences difficulty to eat, which leads to weight loss, dehydration and severe health impairment.